Provider Demographics
NPI:1083825673
Name:DVALERY, RENE F (LMFT)
Entity type:Individual
Prefix:MR
First Name:RENE
Middle Name:F
Last Name:DVALERY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1596 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-2928
Mailing Address - Country:US
Mailing Address - Phone:415-420-5572
Mailing Address - Fax:510-298-5696
Practice Address - Street 1:1275 4TH ST # 5055
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4057
Practice Address - Country:US
Practice Address - Phone:510-451-3000
Practice Address - Fax:510-298-5696
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46693106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist